"When the federal government provides health care for the poor and the middle class, it muscles out states, communities and families that might otherwise fill some of the gap."
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Ah yes the federal government is threatening to "muscle out" all of those non-existent state, community and family health care programs that were working so well for the millions of uninsured last year.

"I'm saying that either Paul Ryan and his House colleagues, blinded by ideology, are wreaking havoc on their party's prospects, or they aren't, and they're not. I can't tell which it is."
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They are. Ryan's giving the Dems twenty years of talking points about how the GOP wants to throw grandma over the cliff. If Ryan and the GOP really want to reform Medicare, they need to be much smarter in their messaging.

If Ryan and the GOP really want to reform Medicare, they need to be much smarter in their messaging.
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They are smart.
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Instead of Medicare as it is, they want to give out "Medicare Stamps" - vouchers - to go along with the "Food Stamps" the low-income elderly get today.
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Then down the road, you cut the amount given in the stamps - Medicare and Food Stamps - or don't increase it to keep up with inflation.
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NPWFTL
Regards

You can't accuse Ryan of throwing Grandma off a cliff; he's contorted the entire budget to make sure that current seniors face no cuts at all. That's my biggest problem with his faux-concern over the deficit: 100% of the burden is shifted to the young, who now have to pay for the current benefits of the old, and their own future healthcare, and do so facing double digit unemployment that's permanently depressed their earnings. But old people vote more, and vote for conservatives, so there's no sharing of the pain by the elderly.

He also wants to slash any program that might help educate the next generation that he's putting this burden on.

Following this path would not hold the older generations harmless. Eventually, future generations would not only find themselves unable to keep the promises made by currently older generations to ourselves on their behalf, they would eventually find themselves with enough votes to undo the damage.

Ryan's scam is to convince as many as possible that they are old enough to escape the payback.

Assuming your premise about shifting burdens to the young, ObamaCare shifted much of the burden to the young as well. Part of expanding the pot to pay for it was by dragging healthy young people into the pools. Social Security works the same way... as do support for Union Pensions and minimum wage requirements that keep teenagers unemployed.

Now that I think of it, a lot of Democrat Party policies screw the young... assuming one survives their mother's pregnancy and becomes a burden on her... so as to then be lucky to get screwed.

Obamacare definitely saw an increased burden on healthy adults between 26 and 40ish who don't want insurance, but those same people also are getting something out it (health insurance), and a big part of what they're losing is the ability to push their emergency costs on everyone else.

Social Security is a different case because the same benefits formula (for now) applies regardless of what year you were born. It's fair that way. What I object to is a politician saying "we must cut this program, but only for people who are less likely to vote for me." If you really want to replace Medicare with Obamacare, you should should want that to apply to everyone, and soon.

We'll all be grandmas and grandpas someday.
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Ryan's plan actually works to preserve the wealth of the 10% of the electorate which own apx. 80% of the assets.
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Otherwise, they'd get taxed to provide services to the less fortunate.

"They are smart."
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Not that smart. When a libertarian like WW writes a long, thoughtful post that in short says "WTF?", you know the GOP has a problem.
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Regarding Medicare Stamps, old people vote, a lot. I doubt with the AARP is too fond of the idea of these stamps...

"What I object to is a politician saying "we must cut this program, but only for people who are less likely to vote for me."

Payback is a pain in politics... My fantasy is to raise taxes just on those that contributed to Obama claiming that they don't pay enough taxes. Specifically, confiscating half of Warren Buffet's and Bill Gates wealth via a special Obama Supporter tax would be beautiful.

What is Paul Ryan doing?
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Re-litigating battles long since decided during the presidencies of TR, Wilson, and FDR. America didn't like the age of Robber Barons as it was living it, and Ryan needs to review his history.

Putting politics aside, let's look at the "unintended consequences" of Ryan's budget "The Path to Prosperity" (TPTP).
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On the plus side, all of the money people have been putting into 401(k)s over the years would probably be taxed at 10% when taken out.
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Does a young person put money into a 401(k), knowing they are just deferring the 10% tax, or will that deduction be taken away?
(Similar to Health Insurance/Social Security described below.)
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Will health insurance premiums and Social Security taxes still be deducted from gross wages when filling out one's 1040?
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At a 25% maginal rate, each $1,000 taxen out drops take-home pay by $750.
Will the 10% rate means the loss of the deduction (-$1,000 take-home) or a reduced deduction (-$900)?
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What is the effect on the Health Savings Accounts?
A person in the 25% tax bracket today can pay for medical bills from the non-taxed money put into an HSA. (Put $500 into the HSA, and your paycheck drops $375, compared to a possible $450 drop IF it is still tax-deducted.)
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I'm sure there are many more question that others can ask.
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NPWFTL
Regards